Some suggest the current physician training and mindsets are prescriptive of disease management, not wellness administration.
By Jay I. Pomerantz, MD – Senior Physician Advisor for Health Integrated

I thought that would get your attention. I have to say that when I read a reference in a recent post on the disease management care blog[1] that alluded to the fact that we physicians may not be capable of preventive care and managing a patient’s ‘wellness’, I had to re-read the post and associated links[2]. Now the author didn’t advocate this perspective, but quoted someone who did. Although I always like to understand and subsequently debate both sides of an argument, I am going to stick to a lopsided, one-way discussion because this one is pretty clear to me. Yes – we physicians are not only capable of dispensing wellness, in that we have a keen understanding of both disease management and overall wellness, but it is our preferred option. (more…)

Can or should a physician segregate their treatment approach for a non-PCMH payer patient from those patients who are PCMH supported?
By Jay I. Pomerantz, MD – Senior Physician Advisor for Health Integrated

We have spent several posts speaking to the merits of PCMH and I continue to support them for all of the reasons we have reviewed.  There is no doubt that when implemented, either on a pilot or a broad basis, a PCMH improves the overall health of the patients enrolled within the program.  As well, the healthplan is able to see significant financial savings based on these health improvements.  For example, utilization of key services like ER visits decrease, as do episodic office visits.  Pharmaceutical compliance increases, which further improves patient health.  Many of the chronic ailments, when dealt with within a PCMH, optimize the patient’s health and thus decrease the associated costs.  This data is readily available through demonstrated implementations in such PCMH pilots as Geisinger, Community Care (NC), Southeastern Pennsylvania Project, North Dakota Blue Cross/Blue Shield[1] and Group Health[2] to name a few.  They have all shown both the clinical and financial success. (more…)

Is the government’s current approach supported by the data?
By Jay I. Pomerantz, MD – Senior Physician Advisor for Health Integrated

After reviewing both the House bill[1] and the recently announced Senate bill, it would appear that healthcare reform is in process. Although there are some seemingly good aspects to both bills, as we have discussed in previous posts, there is still so much that needs to be addressed. To me, some of the burning issues include the redesign of the care delivery model, improving outcomes, addressing the increasing number of people being covered, overall reduction in cost without affecting outcome (and in fact trying to improve outcomes) and countless other key issues. The one area that could use more focus is evidence-based medicine. (more…)